434416115-8-11-2021-07-CC-DSTN-C5YSWF-20210817141417

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434416115
Report Date: 08/11/2021
Date Signed: 08/11/2021 11:03:41 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/02/2021 and conducted by Evaluator Janette Cruz

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20210602134447

FACILITY NAME:	ARMENTA, JULIE & JIM		FACILITY NUMBER:	434416115
ADMINISTRATOR:	JULIE & JIM ARMENTA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 466-7002
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95122
CAPACITY:	14	CENSUS: 13	DATE:	08/11/2021
		UNANNOUNCED	TIME BEGAN:	10:10 AM
MET WITH:	Julie and Jim Armenta		TIME COMPLETED:	11:25 AM

ALLEGATION(S):

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9

Floors of facility are dirty.

Child(ren) not receiving adequate meals.

Licensees not providing comfortable accommodations for distance learning.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs)Janette Cruz and Mel Matos conducted an unannounced follow up complaint investigation and met with Julie and Jim Armenta, Licensees. Purpose of today's follow up complaint investigation: deliver investigation findings.

The investigation of the three allegations listed above was conducted by LPAs Cruz and Matos. Based on the available evidence including observations, record reviews and interviews completed for this complaint investigation, it is concluded that although the allegations noted on this complaint may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. The allegations are thus UNSUBSTANTIATED.
A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 CONSECUTIVE DAYS.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Diana Stephenson	TELEPHONE: (408) 324-2128
LICENSING EVALUATOR NAME: Janette Cruz	TELEPHONE: (408) 334-8312
LICENSING EVALUATOR SIGNATURE:	DATE: 08/11/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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